(Replying to Tricia Shamblin's post, 22nd April)

Hi, Tricia! Replying to a few specific points you raised, first:

1. Not sure why you think that the 'Back to Sleep' campaign wasn't based on clinical studies? It was instigated after multiple case-control studies showed a link between SIDS and stomach-sleeping.

2. All sorts of factors affect the risk of SIDS, so I suspect the reason why rates are so low in the countries you mentioned is that they have much lower prevalences of other risk factors which more than counterbalances any increased risk from the bedsharing.

3. The reason why we can't use RCTs to test hypotheses on risk factors for SIDS is purely practical; not only would we need to find parents who are willing to be randomised to one set of sleeping/feeding conditions or another, we'd need a group size in the tens of thousands to look for differences in SIDS rates between the groups being compared. And then we'd have to do that over again every time to test each different possible contributory factor, while keeping all the others constant. There's simply no way it would ever be feasible. Case-control studies (comparing groups of SIDS babies with groups of surviving babies to  see whether particular factors occur more or less often in one group) are, in practice, the best option we have for investigating SIDS risk factors. It's not ideal, but it's what we've got.


As for general response to your post, I completely agree with your overall point – I'd love to see more of a sensible discussion in which we could help parents weigh up pros and cons of bedsharing. My big concern there is that people from *both* sides seem to try so hard to ignore evidence – whether it's insisting that nobody should ever bedshare without taking into account the possible risks of that approach, or insisting that there's no evidence of any risk because that feels more comfortable than saying “Yes, it looks as if there is a risk, but since it's a very small one in absolute terms let's weigh it up sensibly along with the other pros and cons rather than panicking over it.”


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

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